部分与完全环形腱周缝合对犬尸体肌腱生物力学特性和间隙形成的影响。

Effect of partial vs complete circumferential epitendinous suture placement on the biomechanical properties and gap formation of canine cadaveric tendons.

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.

Joint Department of Biomedical Engineering, North Carolina State University and the University of North Carolina-Chapel Hill, Raleigh, North Carolina.

出版信息

Vet Surg. 2020 Dec;49(8):1571-1579. doi: 10.1111/vsu.13494. Epub 2020 Aug 19.

DOI:10.1111/vsu.13494

PMID:32812666

Abstract

OBJECTIVE

To determine the effect of partial vs complete circumferential epitendinous suture (ES) placement in addition to a core suture on the biomechanical strength and gapping characteristics of repaired canine tendinous constructs.

STUDY DESIGN

Ex vivo, biomechanical study.

SAMPLE POPULATION

Thirty-six canine superficial digital flexor tendons.

METHODS

Superficial digital flexor tendons were randomly assigned to three groups (n = 12), sharply transected and repaired with a core locking-loop suture with Group 1 a partial circumferential ES, 180° on the palmar side; Group 2 a complete circumferential ES, 360° and double knotting technique; or Group 3 a complete circumferential ES, 360° and single knotting technique. After preloading, constructs were distracted to monotonic failure. Failure mode, gap formation, yield, peak, and failure forces were analyzed.

RESULTS

Mean yield (group 1 = 68.6 N, group 2 = 106.5 N, group 3 = 114 N, P < .013), peak (group 1 = 92.8 N, group 2 = 134.6 N, group 3 = 147.3 N; P < .001), and failure (group 1 = 88.7 N, group 2 = 133.0 N, group 3 = 145.5 N, P < .001) loads differed between groups. No difference in yield (P = .874), peak (P = .434), or failure load (P = .434) was detected between complete circumferential ES groups. Force to create 1-mm (P < .001) and 3-mm (P < .038) gap formation was greater in specimens with complete vs partial circumferential ES placement. Complete circumferential ES repairs failed primarily by suture pull-through compared with suture breakage in most partial circumferential ES constructs.

CONCLUSION

Addition of a complete circumferential ES with a single or double knotting technique increased the biomechanical strength of normal tendon repairs while reducing gap formation compared with partial ES placement alone.

CLINICAL SIGNIFICANCE

Complete circumferential ES is recommended over partial ES placement.

摘要

目的

确定在核心缝线之外附加部分或完全环形腱周缝线（ES）对修复的犬肌腱结构的生物力学强度和间隙特征的影响。

研究设计

离体，生物力学研究。

样本人群

36 个犬的浅层指深屈肌腱。

方法

将浅层指深屈肌腱随机分配到三组（每组 12 个），用带核心锁定环缝线进行锐性横断修复。第 1 组为部分环形 ES，掌侧 180°；第 2 组为完全环形 ES，360°并采用双结技术；第 3 组为完全环形 ES，360°并采用单结技术。预加载后，使构建物分散至单调失效。分析失效模式、间隙形成、屈服、峰值和失效力。

结果

平均屈服力（第 1 组=68.6N，第 2 组=106.5N，第 3 组=114N，P<.013）、峰值（第 1 组=92.8N，第 2 组=134.6N，第 3 组=147.3N；P<.001）和失效（第 1 组=88.7N，第 2 组=133.0N，第 3 组=145.5N，P<.001）载荷在各组之间存在差异。完全环形 ES 组之间的屈服力（P=.874）、峰值（P=.434）或失效力（P=.434）无差异。与部分环形 ES 放置相比，完全环形 ES 放置后 1mm（P<.001）和 3mm（P<.038）间隙形成所需的力更大。完全环形 ES 修复主要通过缝线拉脱失效，而大多数部分环形 ES 结构则通过缝线断裂失效。