Gil Joseph A, Chambers Alison, Shah Kalpit N, Crisco Joseph J, Got Christopher, Akelman Edward
1 Brown University, Providence, RI, USA.
Hand (N Y). 2018 Sep;13(5):581-585. doi: 10.1177/1558944717725380. Epub 2017 Aug 24.
A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair.
Nine paired fresh-frozen hands were used for this biomechanical analysis. One thumb from each pair was randomized to the control group and one to the repair group. In the control group, the UCL was loaded to failure in tension. In the repair group, the UCL was dissected off of the proximal phalanx, subsequently repaired with a 2-anchor technique, and then tested to failure.
The mean yield load was 342 N (95% confidence interval [CI], 215-470 N) in the control group and 68 N (95% CI, 45-91 N) in the repair group. The mean maximum load at failure was 379 N (95% CI, 246-513 N) in the control group and 84 N (95% CI, 62-105 N) in the repair group. The mean stiffness was 72 N/m (95% CI, 48-96 N/m) in the control group and 17 N/m (95% CI, 13-21 N) in the repair group. The mean displacement at failure was 7.8 mm (95% CI, 7-9 mm) in the control group and 7.8 mm (95% CI, 7-9 mm) in the repair group.
The 2-anchor repair technique we tested does not acutely reestablish the strength of the insertion of the native insertion of the UCL with this technique.
已证实,用单根缝线锚钉修复的完整拇指尺侧副韧带(UCL)与完整的UCL相比明显更弱。本研究的目的是测试双锚钉修复拇指UCL的生物力学强度。
使用9对新鲜冷冻手进行此生物力学分析。每对中的一只拇指随机分配到对照组,另一只分配到修复组。在对照组中,对UCL施加拉伸直至失效。在修复组中,将UCL从近节指骨上剥离,随后用双锚钉技术进行修复,然后测试至失效。
对照组的平均屈服载荷为342 N(95%置信区间[CI],215 - 470 N),修复组为68 N(95%CI,45 - 91 N)。对照组的平均最大失效载荷为379 N(95%CI,246 - 513 N),修复组为84 N(95%CI,62 - 105 N)。对照组的平均刚度为72 N/m(95%CI,48 - 96 N/m),修复组为17 N/m(95%CI,13 - 21 N)。对照组的平均失效位移为7.8 mm(95%CI,7 - 9 mm),修复组为7.8 mm(95%CI,7 - 9 mm)。
我们测试的双锚钉修复技术并不能通过该技术迅速重建UCL原生附着处的强度。