Department for Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Sci Rep. 2018 Jul 2;8(1):9906. doi: 10.1038/s41598-018-28250-y.
The purpose of this study was to determine the biomechanical characteristics of an innovative surgical technique based on a tension banding principle using a suture anchor in the repair of bony avulsions of the flexor digitorum profundus tendon. After injury simulation in 45 fresh frozen distal phalanges from human cadavers, repair was performed with minifragment screws, interosseous sutures and the innovative technique (15 per group). All repairs were loaded for a total of 500 cycles. Subsequently the specimens were loaded to failure. Load at failure, load at first noteworthy displacement (>2 mm), elongation of the system, gap formation at the avulsion site, and the mechanism of failure were assessed. The new techniques' superior performance in load at failure (mean: 100.5 N), load at first noteworthy displacement (mean 77.4 N), and gap formation (median 0 mm) was statistically significant, which implies a preferable rigidity of the repair. No implant extrusion or suture rupture during cyclic loading were recorded when the new technique was applied. This innovative repair technique is superior biomechanically to other commonly used surgical tendon reattachment methods, particularly with respect to an early passive mobilisation protocol. Further, due to its subcutaneous position, reduction of complications may be achieved.
本研究旨在确定一种基于张紧带原理的创新手术技术的生物力学特性，该技术使用缝线锚钉修复指深屈肌腱骨撕脱伤。在对 45 个人体冷冻手指末节进行损伤模拟后，采用微型骨片螺钉、骨间缝线和创新技术进行修复（每组 15 个）。所有修复均进行了总共 500 次循环加载。随后，对标本进行失效加载。评估失效时的载荷、首次显著位移（>2mm）时的载荷、系统伸长、撕脱部位的间隙形成以及失效机制。新型技术在失效时的载荷（平均值：100.5N）、首次显著位移时的载荷（平均值 77.4N）和间隙形成（中位数 0mm）方面表现出更好的性能，这意味着修复的刚性更好。当应用新型技术时，在循环加载过程中没有记录到植入物挤出或缝线断裂。与其他常用的肌腱再附着手术方法相比，这种创新的修复技术在生物力学方面具有优势，特别是在早期被动活动方案方面。此外，由于其位于皮下，可能会减少并发症。
