指深屈肌修复位置相对于坎珀交叉对肌腱生物力学的影响。

The Effect of Flexor Digitorum Profundus Repair Position Relative to Camper Chiasm on Tendon Biomechanics.

作者信息

Haddara Mohammad M, Mitchell Eric C, Ferreira Louis M, Gillis Joshua

机构信息

Roth | McFarlane Hand and Upper Limb Centre, St Joseph's Health Care London, London, Ontario, Canada; School of Biomedical Engineering, Western University, London, Ontario, Canada.

Roth | McFarlane Hand and Upper Limb Centre, St Joseph's Health Care London, London, Ontario, Canada; Division of Plastic and Reconstructive Surgery, Western University, London, Ontario, Canada.

出版信息

J Hand Surg Am. 2023 Mar;48(3):314.e1-314.e7. doi: 10.1016/j.jhsa.2021.10.024. Epub 2021 Dec 23.

DOI:10.1016/j.jhsa.2021.10.024

PMID:34955320

Abstract

PURPOSE

The purpose of this study was to investigate the impact of repairing a zone II flexor digitorum profundus (FDP) laceration anatomically versus extra-anatomically on tendon loads and work of flexion (WOF).

METHODS

Twenty digits from 5 cadaveric specimens were tested using an in vitro active finger motion simulator under 2 FDP tendon repair conditions: anatomic and extra-anatomic. Tensile loads in FDP and flexor digitorum superficialis (FDS), WOF, and total active finger range of motion (ROM) were measured using in-line load cells and electromagnetic tracking, respectively.

RESULTS

The anatomic repairs had no effect on tendon loads or WOF for either FDP or FDS. The extra-anatomic repairs increased FDP loads by 32% and decreased FDS loads by 9% compared with those in the intact condition. This pattern was similar for WOF following extra-anatomic repairs, which increased FDP WOF by 31% and decreased FDS WOF by 18%. Comparing the 2 repairs, FDP loads and WOF were 25% and 22% greater, respectively, with extra-anatomic repairs compared with anatomic repairs, with no significant change in FDS. Total active ROM was not affected by either repair.

CONCLUSIONS

In this in vitro cadaveric model, extra-anatomic repairs of FDP increased tendon loads and WOF compared with anatomic repairs.

CLINICAL RELEVANCE

On the basis of this study, reconstitution of the anatomic relationship of FDP and FDS at the Camper chiasm during the repair of zone II flexor tendon lacerations is recommended.

摘要

目的

本研究旨在调查在Ⅱ区修复指深屈肌腱（FDP）时，采用解剖修复与非解剖修复对肌腱负荷及屈指功（WOF）的影响。

方法

使用体外主动手指运动模拟器，在两种FDP肌腱修复条件下（解剖修复和非解剖修复），对5具尸体标本的20根手指进行测试。分别使用内置式测力传感器和电磁跟踪技术测量FDP和指浅屈肌（FDS）的拉伸负荷、WOF以及手指总主动活动范围（ROM）。

结果

解剖修复对FDP或FDS的肌腱负荷及WOF均无影响。与完整状态相比，非解剖修复使FDP负荷增加了32%，FDS负荷降低了9%。非解剖修复后的WOF也呈现类似模式，FDP的WOF增加了31%，FDS的WOF降低了18%。比较两种修复方式，与解剖修复相比，非解剖修复的FDP负荷和WOF分别高出25%和22%，FDS无显著变化。两种修复方式均未影响总主动ROM。