Department of Orthopaedics and Traumatology, Faculty of Medicine, Adiyaman University, 02100, Adiyaman, Turkey.
Department of Orthopaedics and Traumatology, Private Park Hospital, Adiyaman, Turkey.
Arch Orthop Trauma Surg. 2020 Apr;140(4):583-590. doi: 10.1007/s00402-020-03384-9. Epub 2020 Mar 4.
To compare five different repair techniques for extensor tendon zone III modified Kessler (MK), double-modified Kessler (DMK), modified Kessler epitendinous (MKE), double-modified Kessler epitendinous (DMKE), and running-interlocking horizontal mattress (RIHM) in terms of shortening, stiffness, gap formation, and ultimate load to failure.
A total of 35 human cadaver fingers were randomly assigned to five suture techniques with 7 fingers each and were tested under dynamic and static loading conditions.
DMK was found to be superior over MK in terms of ultimate load to failure (36 N vs. 24 N, respectively), shortening (1.75 vs. 2.20 mm, respectively) and gap formation. However, these two methods had similar characteristics in terms of stiffness. The addition of epitendinous sutures to the repair methods resulted in approximately 40% increase in ultimate load to failure, whereas epitendinous sutures had no effect on shortening. DMKE was found to be superior over MKE in terms of shortening (1.77 vs. 2.22 mm, respectively). However, these two methods had similar characteristics in terms of mean ultimate load to failure and stiffness. RIHM was found to be superior over the other four methods in terms of ultimate load to failure (89 N), stiffness, and shortening (0.75 mm).
RIHM was found to be stronger and more durable for extensor tendon zone III than the other techniques in terms of ultimate load to failure and stiffness.
比较 5 种不同的修复技术,即伸肌腱区 III 改良 Kessler(MK)、双改良 Kessler(DMK)、改良 Kessler 腱周(MKE)、双改良 Kessler 腱周(DMKE)和连续水平褥式(RIHM)在缩短、刚度、间隙形成和最终失效负载方面的差异。
总共 35 个人体手指尸体被随机分配到 5 种缝线技术中,每种技术有 7 个手指,在动态和静态加载条件下进行测试。
在最终失效负载(分别为 36 N 和 24 N)、缩短(分别为 1.75 和 2.20 毫米)和间隙形成方面,DMK 明显优于 MK。然而,这两种方法在刚度方面具有相似的特征。将腱周缝线添加到修复方法中可使最终失效负载增加约 40%,而腱周缝线对缩短没有影响。DMKE 在缩短方面(分别为 1.77 和 2.22 毫米)明显优于 MKE。然而,这两种方法在平均最终失效负载和刚度方面具有相似的特征。在最终失效负载(89 N)、刚度和缩短(0.75 毫米)方面,RIHM 明显优于其他 4 种方法。
在最终失效负载和刚度方面,RIHM 明显优于其他 4 种方法,对于伸肌腱区 III 来说,它比其他技术更强、更耐用。