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猪屈肌腱中“8”字缝合法和凯斯勒缝合法的体外生物力学研究

In Vitro Biomechanical Study on the "Figure-of-Eight" and Kessler Sutures in Swine Flexor Tendons.

作者信息

Kawachi Diogo Thomaz, Deienno Francisco Simões, Varanda Denis, Cortopassi Andrea Christina, Sardenberg Trajano

机构信息

Departamento de Cirurgia e Ortopedia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (Unesp), Botucatu, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2020 Aug;55(4):445-447. doi: 10.1055/s-0039-1700828. Epub 2020 Jan 9.

Abstract

To evaluate the biomechanical properties of the "figure-of-eight" and Kessler suture techniques for tendons.  Flexor tendons of porcine fingers were divided into two groups with triple central "figure of eight" sutures (six passages) and Kessler sutures (two passages) associated with simple and continuous peripheral sutures, and submitted to continuous longitudinal mechanical tests, to obtain the mechanical properties of maximum load and energy at maximum load.  The mean maximum load and energy at maximum load in the "figure-of-8" suture were of 63.4 N and 217.3 N.mm respectively; in the Kessler suture, the values were of 34.19 N and 100.9 N.mm respectively. The statistical analysis indicated that the "figure-of-eight" suture is mechanically superior to the Kessler technique.  Under the conditions of this experiment and in the flexor tendon of porcine fingers, the triple "figure-of-eight" suture (six passages) is more resistant than the Kessler suture (two passages). The "figure-of-eight" suture with six passages enables active movement in the immediate rehabilitation of the flexor tendon repair of the finger, with little risk of rupture or suture spacing.

摘要

评估“8”字缝合法和凯斯勒缝合法用于肌腱的生物力学特性。将猪手指的屈肌腱分为两组,一组采用三联中央“8”字缝合法(六针通道),另一组采用凯斯勒缝合法(两针通道),并结合简单连续的外周缝合法,进行连续纵向力学测试,以获得最大负荷及最大负荷时能量的力学特性。“8”字缝合法的平均最大负荷及最大负荷时能量分别为63.4 N和217.3 N·mm;凯斯勒缝合法的相应值分别为34.19 N和100.9 N·mm。统计分析表明,“8”字缝合法在力学性能上优于凯斯勒缝合法。在本实验条件下及猪手指屈肌腱中,三联“8”字缝合法(六针通道)比凯斯勒缝合法(两针通道)更具抗拉力。有六针通道的“8”字缝合法可使手指屈肌腱修复术后早期康复时进行主动活动,且破裂或缝线间距风险小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6925/7458735/6f90c91a1806/10-1055-s-0039-1700828-i1900057en-1.jpg

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