不同核心缝线长度对用于屈肌腱修复的多股缝线拉伸强度的影响。
Effects of Different Core Suture Lengths on Tensile Strength of Multiple-Strand Sutures for Flexor Tendon Repair.
作者信息
Chinen Shuko, Okubo Hirotaka, Kusano Nozomu, Kinjo Masaki, Kanaya Fuminori, Nishida Kotaro
机构信息
Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
Department of Orthopedic Surgery, Tominaga-Kusano Hospital, Niigata, Japan.
出版信息
J Hand Surg Glob Online. 2020 Nov 13;3(1):41-46. doi: 10.1016/j.jhsg.2020.10.006. eCollection 2021 Jan.
PURPOSE
To compare 2 types of newly devised 8-strand quadruple-looped suture (QLS) techniques with a 6-strand triple-looped suture (TLS) technique; and to assess the effects of different core suture lengths (CSLs) (the length between 2 locking sites of a suture strand) within each suture row on tensile strength.
METHODS
We repaired 24 flexor tendons from 12 rabbits using the TLS and QLS techniques, with equal CSL (QLS) or unequal CSL (unequal QLS) among each suture row. The QLS was composed of 4 looped sutures on the anterolateral and posterolateral aspects of the tendon. The cross-sectional area of the locking portion of each thread in the QLS was equal to that in the TLS. In the QLS technique, the CSL on each aspect of the tendon was 13 mm. In the unequal QLS technique, the CSL on each aspect of the tendon was 13 and 17 mm. The load at 1- and 2-mm gaps, the maximum load until the 3-mm gap, and the ultimate load were compared among the 3 techniques.
RESULTS
The QLS was significantly stronger than the unequal QLS and the TLS for loads at 1-mm and 2-mm gaps, maximum load until 3-mm gap, and ultimate load. There was no significant difference between the unequal QLS and TLS techniques. The QLS technique showed an approximately 30% increase in gap resistance and ultimate strength compared with the TLS technique.
CONCLUSIONS
The QLS technique showed an estimated increase in tensile strength proportional to the number of suture strands compared with the TLS technique. Our study suggests that a consistent CSL in each suture row provides the highest strength in multistrand sutures consisting of the same configuration of suture rows.
CLINICAL RELEVANCE
The QLS technique may reduce the risk for tendon rupture associated with early active mobilization after flexor tendon repair.
目的
比较两种新设计的8股四重环缝合法（QLS）技术与一种6股三重环缝合法（TLS）技术；并评估每排缝线内不同的缝线核心长度（CSL，即缝线股线两个锁定点之间的长度）对拉伸强度的影响。
方法
我们使用TLS和QLS技术修复了12只兔子的24条屈指肌腱，每排缝线的CSL相等（QLS）或不相等（不等QLS）。QLS由肌腱前外侧和后外侧的4个环行缝线组成。QLS中每根线的锁定部分的横截面积与TLS中的相等。在QLS技术中，肌腱各面的CSL为13毫米。在不等QLS技术中，肌腱各面的CSL分别为13毫米和17毫米。比较了这三种技术在1毫米和2毫米间隙时的负荷、3毫米间隙前的最大负荷以及极限负荷。
结果
对于1毫米和2毫米间隙时的负荷、3毫米间隙前的最大负荷以及极限负荷，QLS明显强于不等QLS和TLS。不等QLS和TLS技术之间无显著差异。与TLS技术相比，QLS技术的抗间隙能力和极限强度提高了约30%。
结论
与TLS技术相比，QLS技术显示出拉伸强度的增加与缝线股数成正比。我们的研究表明，在由相同缝线排配置组成的多股缝线中，每排缝线一致的CSL可提供最高强度。
临床意义
QLS技术可能降低屈指肌腱修复后早期主动活动相关的肌腱断裂风险。
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