两种缝线材料和两种缝合法组合在马属动物的浅背侧屈肌腱腱修复中的体外生物力学比较。

An ex vivo biomechanical comparison of two suture materials and two pattern combinations for equine superficial digital flexor tendon tenorrhaphy.

机构信息

Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, Glasgow, UK.

出版信息

Vet Surg. 2021 Jul;50(5):1137-1146. doi: 10.1111/vsu.13658. Epub 2021 May 13.

DOI:10.1111/vsu.13658

PMID:33982804

Abstract

OBJECTIVE

To compare biomechanical characteristics of three-loop pulley (3LP) pattern versus Bunnell technique (BT) using polydioxanone (PDS) suture; to determine the influence of polyester tape (PT) versus PDS on the BT for equine superficial digital flexor tendon (SDFT) tenorrhaphy; to compare BT with PT versus 3LP with PDS.

STUDY DESIGN

Ex vivo biomechanical study.

SAMPLE POPULATION

Forty equine forelimb SDFT.

METHODS

Two experiments were performed: (1) 10 SDFT pairs were repaired with 3LP or BT using PDS; (2) 10 SDFT pairs were repaired with PDS or PT using BT. Load at failure, mode of failure, load at 2 mm gap, and gap at failure were obtained using a material testing machine.

RESULTS

In experiment 1, 3LP + PDS had higher loads at failure (p < .001) and at 2 mm gap (p < .001), and smaller gap at failure than BT + PDS (p = .024). In experiment 2, BT + PT had higher loads at failure (p < .001) and at 2 mm gap (p = .001), and larger gap at failure (p = .004) than the BT + PDS . 3LP + PDS and BT + PT mostly failed by suture/implant pull-through while BT + PDS failed by suture breakage. BT + PT had greater load (p = .035) and gap at failure (p < .001) than 3LP + PDS with no difference in load at 2 mm gap (p = .14).

CONCLUSION

The use of BT may be justified over 3LP if combined with PT. However, the larger size of the PT required stab incisions in the tendon for placement and was subjectively more difficult to place than PDS.

CLINICAL SIGNIFICANCE

The BT + PT, although the strongest among the tested repairs, would only be able to withstand 12%-24% of the load encountered by the SDFT at walk.

摘要

目的

比较三圈滑线（3LP）与邦内尔（Bunnell）技术（BT）修复聚二氧杂环已酮（PDS）缝线对马属动物浅背侧指深屈肌腱（SDFT）的生物力学特性；确定聚酯带（PT）与 PDS 对 BT 修复 SDFT 的影响；比较 BT 与 PT 与 3LP 与 PDS。

研究设计

体外生物力学研究。

样本人群

40 个马前肢 SDFT。

方法

进行了两项实验：（1）用 3LP 或 BT 用 PDS 修复 10 对 SDFT；（2）用 PDS 或 PT 用 BT 修复 10 对 SDFT。使用材料试验机获得失效时的负载、失效模式、2mm 间隙时的负载和失效时的间隙。

结果

在实验 1 中，3LP+PDS 的失效负载（p<0.001）和 2mm 间隙负载（p<0.001）更高，失效时的间隙更小（p=0.024）BT+PDS。在实验 2 中，BT+PT 的失效负载（p<0.001）和 2mm 间隙负载（p=0.001）更高，失效时的间隙更大（p=0.004）BT+PDS。3LP+PDS 和 BT+PT 主要通过缝线/植入物拉脱失效，而 BT+PDS 则通过缝线断裂失效。BT+PT 的负载（p=0.035）和失效时的间隙（p<0.001）大于 3LP+PDS，但 2mm 间隙时的负载无差异（p=0.14）。