Iwase Dai, Uchida Kentaro, Metoki Yukie, Sekiguchi Hiroyuki, Aikawa Jun, Matsuo Takashi, Matsuo Atsushi, Takaso Masashi
Department of Orthopaedic Surgery, Kitasato University, School of Medicine, Sagamihara, JPN.
Medical Sciences Research Institute, Shonan University, Chigasaki, JPN.
Cureus. 2020 Dec 30;12(12):e12387. doi: 10.7759/cureus.12387.
Background There are many reports of Achilles tendon lengthening procedures for equinus deformity of the ankle. We previously modified an Achilles tendon lengthening to prevent overextension with a locking mechanism suture before performing a sliding lengthening. The purpose of this study was to compare the biomechanical properties of the locking mechanism suture with sliding lengthening (L-SL) and Z-lengthening (ZL) using a rabbit model. Methods Thirty-six male Japanese white rabbits were assigned to two groups - half undergoing the L-SL technique and half undergoing the ZL technique on the flexor hallucis longus (FHL) tendon. Six rabbits in each group were sacrificed at one week, three weeks, and six weeks postoperatively and evaluated, while five rabbits underwent radiographical and biomechanical evaluation and one underwent histological evaluation. Results In extension length, L-SL was significantly lower than ZL one week postoperatively. In the L-SL group, elongation one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ultimate failure load, L-SL was significantly higher than ZL one and three weeks after lengthening. In the L-SL group, the ultimate failure load one week postoperatively was significantly lower than that three and six weeks postoperatively. In the ZL group, there were significant differences at all time points. Conclusion L-SL had higher mechanical property in vivo.
有许多关于踝关节马蹄足畸形跟腱延长手术的报道。我们之前改良了一种跟腱延长术，在进行滑动延长之前，通过锁定机制缝合来防止过度伸展。本研究的目的是使用兔模型比较锁定机制缝合与滑动延长术（L-SL）和Z形延长术（ZL）的生物力学特性。方法：将36只雄性日本白兔分为两组——一半接受L-SL技术，另一半接受ZL技术用于拇长屈肌腱（FHL）。每组6只兔子在术后1周、3周和6周处死并进行评估，5只兔子接受影像学和生物力学评估，1只接受组织学评估。结果：在延长长度方面，术后1周L-SL明显低于ZL。在L-SL组中，术后1周的伸长明显低于术后3周和6周。在极限破坏载荷方面，延长后1周和3周L-SL明显高于ZL。在L-SL组中，术后1周的极限破坏载荷明显低于术后3周和6周。在ZL组中，所有时间点均有显著差异。结论：L-SL在体内具有更高的力学性能。
